PROVIDENCE ST JOSEPH MEDICAL CENTER: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PROVIDENCE ST JOSEPH MEDICAL CENTER (EIN 81-0463482)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-10
- IRS object ID
- 201713149349302761
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-10T13:00:47-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911194016 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clark Nuber PS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4th Suite 1400 | AddressLine1Txt |
| City | Bellevue | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810463482 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Providence St Joseph Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PROV | BusinessNameControlTxt |
| Phone | 4255253985 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Avenue SW No 9016 | AddressLine1Txt |
| City | Renton | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 980579016 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jo Ann Escasa-Haigh | PersonNm |
| Person Title | EVP/CFO - Operations | PersonTitleTxt |
| Phone | 4255253985 | PhoneNum |
| Signature | 2017-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Sara Elizabeth J Hyre CPA | PreparerPersonNm |
| PTIN | P00235495 | PTIN |
| Phone | 4254544919 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 170.173.0.16 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-10 | IPDt |
| IP Tm | 11:00:27 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C5F3CFF4C26DED891B80F887CA75C12EDBBE0CDF | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C5F3CFF4C26DED891B80F887CA75C12EDBBE0CDF | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Mike Butler | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Avenue SW No 9016 | AddressLine1Txt |
| City | Renton | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 980579016 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $34,659,781 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://montana.providence.org/hospitals/st-joseph | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | Healthcare with special concern for the poor and vulnerable in Polson, MT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 313 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $748,056 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$203,391 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $655,103 | PYContributionsGrantsAmt |
| CY Contributions Grants | $161,749 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $26,864,146 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,974,939 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12,338 | PYInvestmentIncomeAmt |
| CY Investment Income | $18,055 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,544,220 | PYOtherRevenueAmt |
| CY Other Revenue | $470,440 | CYOtherRevenueAmt |
| PY Total Revenue | $30,075,807 | PYTotalRevenueAmt |
| CY Total Revenue | $34,625,183 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $15,440 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $73,130 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,549,025 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,851,948 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,950,315 | PYOtherExpensesAmt |
| CY Other Expenses | $21,905,760 | CYOtherExpensesAmt |
| PY Total Expenses | $32,514,780 | PYTotalExpensesAmt |
| CY Total Expenses | $38,830,838 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,438,973 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$4,205,655 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,965,192 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,356,241 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,353,163 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,373,788 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,612,029 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,982,453 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | As People of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service.Healthcare w/ special concern for the poor & vulnerable in Polson, MT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $19,375,257 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $21,151,382 | RevenueAmt |
| Desc | ACUTE CARE - INPATIENT700 AdmissionsAcute Patient Days - 2,316ACUTE CARE - OUTPATIENT44,620 Patient VisitsProvidence St. Joseph Medical Center is a 22 bed acute care hospital providing a wide range of medical services to the community without regard to the patient's ability to pay for these services. Included in operations is a primary clinic practice and an assisted living facility.OUR MISSION - As people of Providence, we reveal God's love for all, especially the poor and vulnerable, through our compassionate service. OUR CORE VALUES - Respect, Compassion, Justice, Excellence, and StewardshipFebruary is Heart Health Month and here at St. Joes we continue to show our commitment to community health and wellness. NATIONAL WEAR RED DAYProvidence St. Joseph Medical Center encouraged caregivers to wear red on National Wear Red Day, Friday February 5th, 2016 in an effort to raise awareness about women's health. 80% of cardiac events in women could be prevented if women made the right choices for their hearts involving diet, exercise and abstinence from smoking. During February St Joes offered the following screenings:LIPID PROFILE Community members received a Lipid Profile at no charge.CARDIAC HEALTH PROFILECommunity members were also offered a Cardiac Health Profile. This profile included: Complete Metabolic Panel, Complete Blood Count & Thyroid Stimulating Hormone lab tests. BASELINE EKGAll EKGs were read by a cardiologist from the International Heart Institute in Missoula.CPR CLASSESFREE Heart Saver CPR classes were offered in February. In honor of Heart Health Month, Providence St. Joseph Medical Center held courses in February and conducted the classroom, video-based course to teach adult CPR and AED use, as well as how to relieve choking in an adult. This course was for anyone with limited or no medical training who needed a course completion card in CPR and AED use to meet job requirements or for general preparedness. REACH AND READ PROGRAM:Providence St. Joseph Medical Center caregivers introduced the Reach Out and Read Program to St. Joe's.Reach Out and Read is a nonprofit organization that gives young children a foundation for success by incorporating books into pediatric care and encouraging families to read aloud together.The Reach Out and Read evidence-based program builds on the unique relationship between parents and medical providers to develop critical early reading skills in children, beginning in infancy. As recommended by the American Academy of Pediatrics, Reach Out and Read incorporates early literacy into pediatric practice, equipping parents with tools and knowledge to ensure that their children are prepared to learn when they start school.Reach Out and Read serves nearly 4.5 million children and their families annually. Reach Out and Read families read together more often, and their children enter kindergarten with larger vocabularies and stronger language skills. During the preschool years, children served by Reach Out and Read score three to six months ahead of their non-Reach Out and Read peers on vocabulary tests. These early foundational language skills help start children on a path of success when they enter school.A new physician joined the surgical staff at Providence St. Joseph Medical Center. The physician joined the growing group of surgeons dedicated to serving Lake County and the Mission Valley. As the only full-time general surgeon in our community, the physician offers nearly a decade of experience in a range of procedures, including colonoscopies, hernia repair and gall bladder and appendix surgeries. He joins our team already providing surgical expertise in orthopedics and OB-GYN.28 caregivers from Providence St. Joseph Medical Center and the Montana Cancer Center participated in the 8th annual Women 4 Wellness event.Caregivers representing St. Joseph's OB-GYN and family practice departments were on hand supplying information. A pediatrician was on hand, plus caregivers supplying information about immunizations and the Lake Shore Pharmacy. The true heroes were the caregivers who drew blood for the free Comprehensive Metabolic Panels, Complete Blood Count and Thyroid Stimulating Hormone tests. Over 300 tests were performed.Montana Governor Steve Bullock visited Providence St. Joseph Medical Center in September. The stop was part of the governor's "Innovate & Educate" tour which highlights new education initiatives. The governor was interested in learning about the Polson High School - Providence St. Joseph Medical Center Student Internship Program. Governor Bullock spent about 20 minutes interacting with program administrators and former students and then another 25 minutes visiting various hospital departments before concluding his tour.The Montana Superintendent of Public Instruction visited Providence St. Joseph Medical Center in September to receive first-hand knowledge of the St. Joseph and Polson High School Student Internship Program.She met with past and current students, school administrators and St. Joseph program directors to learn more about the program. She was interested in finding out what makes the program successful and what challenges were faced. Providence St. Joseph Medical Center celebrated Breast Cancer Awareness month with three Pinkalicious Ladies Night Out events. Community members were offered free mammograms. OB/GYNs were available to answer questions and offer breast exams. The arrival of a new pediatrician marks the first permanent pediatrician on staff at the hospital in five years, and she becomes the only full-time pediatrician serving patients from Arlee to the shores of Flathead Lake.A naturopathic physician from Providence Medical Group - Women's Care and Family Wellness in Missoula, began a monthly outreach to Providence St. Joseph Medical Center in Polson.As a specialist in naturopathic medicine, the physician treats the whole body, not just the disease or pathology. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $9,686,360 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $10,574,306 | RevenueAmt |
| Desc | Primary Care - 39,963 VisitsSEE PART III, Line 4a. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,375,137 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,602,485 | RevenueAmt |
| Desc | LTC/Hospice/Housing & Assisted Living - 13,963 Days for Long-Term Care/Asst.St. Joseph Assisted Living is the first phase of St. Joseph Retirement Community, a multi-phase senior retirement campus located on the grounds of St. Joseph Hospital in Polson, MT. The Assisted Living Center was thoughtfully designed with the purpose of creating a warm and comfortable atmosphere. The library/living area is an irresistible gathering place where the warmth of fireplaces mingles with beautiful art and furnishings.The centrally located dining room serves nutritious, home cooked meals three times a day in a pleasant and social environment.The Assisted Living Program is based on the principles of choice, dignity, independence, privacy, individuality and homelike surroundings. The program is designed for seniors who desire or need to have some additional personal assistance with managing their daily activities. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $73,130 | ExpenseAmt |
| Grant | $73,130 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Grants & Allocations - Various grants were made to local organizations in an attempt to create healthier communities together. This included funding for sports physical exams. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $73,130 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $73,130 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $30,509,884 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 313 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Karl E Fritschel CPA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4255253339 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 Lind Ave SW 9016 | AddressLine1Txt |
| City | Renton | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 980579016 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (57 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Richard Blair | ||||||||||
| Chair - Eff. 7/16 | 0.10 | 4.60 | Yes (X) | Yes (X) | $0 | $30,180 | $0 | |||
| Dave Olsen | ||||||||||
| Vice Chair - Eff. 7/16 | 0.10 | 5.50 | Yes (X) | Yes (X) | $0 | $24,135 | $0 | |||
| Dick P Allen | ||||||||||
| Director - Eff. 7/16 | 0.10 | 2.00 | Yes (X) | $0 | $15,180 | $0 | ||||
| Isiaah Crawford | ||||||||||
| Director | 0.10 | 4.10 | Yes (X) | $0 | $24,360 | $0 | ||||
| Sister Lucille Dean SP | ||||||||||
| Director - Eff. 7/16 | 0.10 | 2.10 | Yes (X) | $0 | $0 | $0 | ||||
| Sister Diane Hejna CSJ RN | ||||||||||
| Director - Eff. 7/16 | 0.10 | 1.90 | Yes (X) | $0 | $0 | $0 | ||||
| Michael Holcomb | ||||||||||
| Director /Chair Thru 6/16 | 0.10 | 5.30 | Yes (X) | Yes (X) | $0 | $45,360 | $0 | |||
| Phyllis Hughes RSM | ||||||||||
| Director | 0.10 | 5.00 | Yes (X) | $0 | $0 | $0 | ||||
| Sallye Liner | ||||||||||
| Director | 0.10 | 4.70 | Yes (X) | $0 | $20,360 | $0 | ||||
| Mary Lyons PhD | ||||||||||
| Director - Eff. 7/16 | 0.10 | 1.50 | Yes (X) | $0 | $15,180 | $0 | ||||
| Walter Noce Jr | ||||||||||
| Director - Eff. 7/16 | 0.10 | 2.00 | Yes (X) | $0 | $15,180 | $0 | ||||
| Carolina Reyes MD | ||||||||||
| Director | 0.10 | 4.60 | Yes (X) | $0 | $22,860 | $0 | ||||
| Phoebe Yang | ||||||||||
| Director - Eff. 7/16 | 0.10 | 2.00 | Yes (X) | $0 | $12,680 | $0 | ||||
| Fr Tom Kopfensteiner | ||||||||||
| Director - Res. 12/16 | 0.10 | 2.00 | Yes (X) | $0 | $6,400 | $0 | ||||
| Chauncey Boyle SP | ||||||||||
| Director - Thru 6/16 | 0.10 | 3.10 | Yes (X) | $0 | $0 | $0 | ||||
| Marian Schubert CSJ | ||||||||||
| Director - Thru 6/16 | 0.10 | 2.80 | Yes (X) | $0 | $0 | $0 | ||||
| Michael A Stein | ||||||||||
| Director - Thru 6/16 | 0.10 | 3.10 | Yes (X) | $0 | $7,680 | $0 | ||||
| Eugene Al Parrish | ||||||||||
| Director - Thru 6/16 | 0.10 | 2.80 | Yes (X) | $0 | $7,680 | $0 | ||||
| Bob Wilson | ||||||||||
| Director - Thru 6/16 | 0.10 | 2.90 | Yes (X) | $0 | $9,120 | $0 | ||||
| Martha Diaz Aszkenazy | ||||||||||
| Director - Thru 6/16 | 0.10 | 3.90 | Yes (X) | $0 | $9,180 | $0 | ||||
| Kirby McDonald | ||||||||||
| Director - Thru 6/16 | 0.10 | 2.80 | Yes (X) | $0 | $7,680 | $0 | ||||
| Charles Chuck Watts | ||||||||||
| Director - Thru 6/16 | 0.10 | 2.80 | Yes (X) | $0 | $9,180 | $0 | ||||
| Rod F Hochman MD | ||||||||||
| President / CEO - Thru 6/16 | 0.10 | 64.90 | Yes (X) | $0 | $4,060,921 | $43,543 | ||||
| Mike Butler | ||||||||||
| President - Eff. 7/16 | 0.10 | 59.90 | Yes (X) | $0 | $6,906,693 | $349,633 | ||||
| Todd Hofheins | ||||||||||
| EVP/CFO /Treas. Thru 11/16 | 0.10 | 59.90 | Yes (X) | $0 | $1,571,440 | $60,670 | ||||
| Jo Ann Escasa-Haigh | ||||||||||
| Interim CFO/Treasurer | 0.10 | 49.90 | Yes (X) | $0 | $755,416 | $168,190 | ||||
| Cindy Strauss | ||||||||||
| EVP/Chief Legal Officer | 0.10 | 59.90 | Yes (X) | $0 | $1,462,780 | $58,266 | ||||
| Jeff Fee | ||||||||||
| CE/Western MT. Region | 10.00 | 40.00 | Yes (X) | $0 | $599,953 | $102,582 | ||||
| James Kiser | ||||||||||
| CEO/PSJMC | 45.00 | 0.00 | Yes (X) | $279,569 | $0 | $29,210 | ||||
| Debra Canales | ||||||||||
| EVP/CAO | 0.10 | 59.90 | $0 | $2,092,357 | $611,609 | Yes (X) | ||||
| Janice Newell | ||||||||||
| SVP/Chief Information Officer | 0.10 | 59.90 | $0 | $1,137,493 | $34,098 | Yes (X) | ||||
| Joel Gilbertson | ||||||||||
| SVP/Community Partnerships | 0.10 | 59.90 | $0 | $842,027 | $247,847 | Yes (X) | ||||
| Orest Holubec | ||||||||||
| SVP/Chief Comm./Ext. Affairs Officer | 0.10 | 54.90 | $0 | $782,688 | $207,806 | Yes (X) | ||||
| Greg Till | ||||||||||
| VP/Chief Talent Officer | 0.10 | 64.90 | $0 | $776,011 | $122,367 | Yes (X) | ||||
| Sharon Toncray | ||||||||||
| SVP / Chief Labor Employee Counsel | 0.10 | 59.90 | $0 | $764,977 | $243,728 | Yes (X) | ||||
| Jack Mudd - Thru 316 | ||||||||||
| SVP/Mission Leadership | 0.10 | 28.90 | $0 | $718,728 | $157,778 | Yes (X) | ||||
| Paul Stoddart - Thru 916 | ||||||||||
| VP/Marketing | 0.10 | 54.90 | $0 | $641,423 | $22,381 | Yes (X) | ||||
| Robert Hellrigel | ||||||||||
| SVP-CE / Senior & Comm. Services | 0.10 | 54.90 | $0 | $620,281 | $196,789 | Yes (X) | ||||
| Mark Gargett | ||||||||||
| VP/Digital Integration | 0.10 | 49.90 | $0 | $610,787 | $65,970 | Yes (X) | ||||
| David Brown | ||||||||||
| VP/Strategy & Business Development | 0.10 | 54.90 | $0 | $700,461 | $226,430 | Yes (X) | ||||
| Debbie Burton | ||||||||||
| SVP/ Chief Nrsg. Officer | 0.10 | 59.90 | $0 | $713,480 | $90,015 | Yes (X) | ||||
| Mary Cranstoun | ||||||||||
| VP/Total Rewards | 0.10 | 59.90 | $0 | $663,031 | $114,417 | Yes (X) | ||||
| Aaron Martin | ||||||||||
| SVP/Strategy & Innovation | 0.10 | 69.90 | $0 | $852,934 | $219,285 | Yes (X) | ||||
| Tom McDonagh | ||||||||||
| VP/Chief Investment Officer | 0.10 | 57.90 | $0 | $849,462 | $53,521 | Yes (X) | ||||
| Rhonda Medows MD | ||||||||||
| EVP/Population Health | 0.10 | 59.90 | $0 | $1,565,700 | $320,279 | Yes (X) | ||||
| Harvey Smith | ||||||||||
| SVP/Chief Customer Svc. Officer | 0.10 | 49.90 | $0 | $1,226,156 | $23,791 | Yes (X) | ||||
| Lisa Vance | ||||||||||
| SVP/Clinical Program Services | 0.10 | 59.90 | $0 | $1,220,348 | $125,445 | Yes (X) | ||||
| Mike Waters | ||||||||||
| VP,CAO/Physician Services | 0.10 | 64.90 | $0 | $703,777 | $184,023 | Yes (X) | ||||
| Amy Compton-Phillips | ||||||||||
| EVP/Chief Clinical Officer | 0.10 | 54.90 | $0 | $1,113,493 | $278,894 | Yes (X) | ||||
| Michael Righetti MD | ||||||||||
| Physician - Orthopedics | 50.00 | 0.00 | $599,231 | $0 | $24,772 | Yes (X) | ||||
| Joseph Howard MD | ||||||||||
| Physician | 50.00 | 0.00 | $346,948 | $0 | $21,337 | Yes (X) | ||||
| Kenneth Galewyrick MD | ||||||||||
| Physician | 50.00 | 0.00 | $372,958 | $0 | $21,016 | Yes (X) | ||||
| Robin Hape MD | ||||||||||
| Physician - Surgery | 50.00 | 0.00 | $303,720 | $0 | $19,469 | Yes (X) | ||||
| Rebecca Bontadelli MD | ||||||||||
| ER Physician | 50.00 | 0.00 | $292,551 | $0 | $26,731 | Yes (X) | ||||
| Craig Wright MD | ||||||||||
| SVP/Physician Services | 0.00 | 0.00 | $0 | $1,119,939 | $20,455 | Yes (X) | ||||
| Jack Friedman | ||||||||||
| SVP/Accountable Care & Payor Rel. | 0.00 | 0.00 | $0 | $299,327 | $0 | Yes (X) | ||||
| Randy Axelrod MD | ||||||||||
| EVP/Clinical & Patient Services | 0.00 | 0.00 | $0 | $1,419,333 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,194,977 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $37,073,811 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $4,492,347 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 32 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Mission Valley Anesthesia Assoc | |||||
| Glacier Bank 49430 US Highway 93 | Polson | MT | 59860 | Staffing | $650,409 |
| Thomas Cuisine Corporation | |||||
| PO Box 1010 | Polson | MT | 59860 | Dietary/Food & Nutrition Management | $404,344 |
| Cross Country Staffing Inc | |||||
| LA Lockbox File 50941 | Los Angeles | CA | 90074 | Staffing | $382,180 |
| Alliance Healthcare Services Inc | |||||
| LA Lockbox File 55826 | Los Angeles | CA | 90074 | Imaging Services | $318,577 |
| MT Cancer Specialists | |||||
| PO Box 7877 | Missoula | MT | 59807 | Staffing | $102,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $345 | FundraisingAmt |
| Related Organizations | $100,991 | RelatedOrganizationsAmt |
| Government Grants | $55,746 | GovernmentGrantsAmt |
| All Other Contributions | $4,667 | AllOtherContributionsAmt |
| Total Contributions | $161,749 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Acute Care | 621400 | $20,126,510 | $20,126,510 | |
| Primary Care | 621110 | $10,061,937 | $10,061,937 | |
| Pharmacy | 446110 | $2,358,036 | $1,609,980 | $748,056 |
| LTC/Home Care | 621610 | $1,428,456 | $1,428,456 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,974,939 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,055 | TotalRevenueColumnAmt |
| Exclusion | $18,055 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $35,780 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $13,182 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,598 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,598 | TotalRevenueColumnAmt |
| Exclusion | $22,598 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $7,500 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $345 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $7,500 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $16,213 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $13,916 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,297 | TotalRevenueColumnAmt |
| Exclusion | $2,297 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|
| Cafeteria | 900099 | $217,353 | $217,353 | |
| Gain on Refinancing | 900099 | $110,280 | $110,280 | |
| Managed Care | 900099 | $101,290 | $101,290 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,622 | TotalRevenueColumnAmt |
| Exclusion | $16,622 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $445,545 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,625,183 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,328,173 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $748,056 | UnrelatedBusinessRevenueAmt |
| Exclusion | $387,205 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,508 | TotalAmt |
| Program Services | $70,508 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,622 | TotalAmt |
| Program Services | $2,622 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,699 | TotalAmt |
| Management And General | $293,699 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,269,118 | TotalAmt |
| Program Services | $14,068,625 | ProgramServicesAmt |
| Management And General | $1,200,493 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,344 | TotalAmt |
| Program Services | $223,917 | ProgramServicesAmt |
| Management And General | $9,427 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,319 | TotalAmt |
| Program Services | $45,529 | ProgramServicesAmt |
| Management And General | $4,790 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,005,468 | TotalAmt |
| Program Services | $909,759 | ProgramServicesAmt |
| Management And General | $95,709 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,430 | TotalAmt |
| Management And General | $1,430 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85 | TotalAmt |
| Management And General | $85 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $850 | TotalAmt |
| Management And General | $850 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,424,822 | TotalAmt |
| Program Services | $2,306,902 | ProgramServicesAmt |
| Management And General | $117,920 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,908 | TotalAmt |
| Program Services | $28,908 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,253,334 | TotalAmt |
| Program Services | $1,134,031 | ProgramServicesAmt |
| Management And General | $119,303 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,535 | TotalAmt |
| Program Services | $47,535 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $550,871 | TotalAmt |
| Program Services | $413,153 | ProgramServicesAmt |
| Management And General | $137,718 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,250 | TotalAmt |
| Program Services | $83,379 | ProgramServicesAmt |
| Management And General | $42,871 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,890 | TotalAmt |
| Program Services | $61,072 | ProgramServicesAmt |
| Management And General | $14,818 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,202 | TotalAmt |
| Program Services | $321,202 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,970,882 | TotalAmt |
| Program Services | $5,112,708 | ProgramServicesAmt |
| Management And General | $5,858,174 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $893,155 | TotalAmt |
| Program Services | $669,866 | ProgramServicesAmt |
| Management And General | $223,289 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $4,372,587 | $4,372,587 | |
| Bad Debts | $387,454 | $387,454 | |
| Recruitment/Relocation | $230,315 | $176,548 | $53,767 |
| Dues & Subscriptions | $125,716 | $37,939 | $87,777 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,474 | TotalAmt |
| Program Services | $35,640 | ProgramServicesAmt |
| Management And General | $58,834 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,830,838 | TotalAmt |
| Program Services | $30,509,884 | ProgramServicesAmt |
| Management And General | $8,320,954 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,750 | BOYAmt |
| EOY | $1,750 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,432,315 | BOYAmt |
| EOY | $1,311,588 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,851,360 | BOYAmt |
| EOY | $3,687,827 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $849 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $907,125 | BOYAmt |
| EOY | $793,815 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,231 | BOYAmt |
| EOY | $75,495 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $24,260,112 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,484,690 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,460,722 | BOYAmt |
| EOY | $6,775,422 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,986,893 | BOYAmt |
| EOY | $2,008,608 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $215,063 | BOYAmt |
| EOY | $528,602 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,055,733 | BOYAmt |
| EOY | $1,172,285 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,965,192 | BOYAmt |
| EOY | $16,356,241 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,214,657 | BOYAmt |
| EOY | $1,660,902 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,562 | BOYAmt |
| EOY | $121,813 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,163,769 | BOYAmt |
| EOY | $7,611,744 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $399,964 | BOYAmt |
| EOY | $409,982 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,460,083 | BOYAmt |
| EOY | $4,569,347 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,353,163 | BOYAmt |
| EOY | $14,373,788 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,379,522 | BOYAmt |
| EOY | $1,436,407 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,507 | BOYAmt |
| EOY | $546,046 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,612,029 | BOYAmt |
| EOY | $1,982,453 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,965,192 | BOYAmt |
| EOY | $16,356,241 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$4,205,655 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,398 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $4,573,681 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $85 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $85 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Payment of dues to the Montana Hospital Association to represent healthcare interests with government entities. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $235,295 | OtherCostOrOtherBasisAmt |
| Book Value | $235,295 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,813,150 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,501,886 | DepreciationAmt |
| Book Value | $4,311,264 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $714,150 | OtherCostOrOtherBasisAmt |
| Depreciation | $628,016 | DepreciationAmt |
| Book Value | $86,134 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,485,017 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,354,788 | DepreciationAmt |
| Book Value | $2,130,229 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,500 | OtherCostOrOtherBasisAmt |
| Book Value | $12,500 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,775,422 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (8 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Unamortized Bond Finance Costs | $26,701 |
| Due from Affiliates | $154,060 |
| CSV Life Insurance | $17,533 |
| Third Party Settlements | $427,899 |
| Resident Trust Fund | $522 |
| Provider Tax Receivable | $538,080 |
| Cash - Residents | $198 |
| Trustee Held Funds | $7,292 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,172,285 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Third Party Settlements | $639,078 |
| Due to Affiliates | $3,846,197 |
| Resident Trust Account | $522 |
| SJRC Trust Account | $26,200 |
| Provider Tax Payable | $57,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,569,347 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent350 | Yes (X) | Percent350Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 176 | PersonsServedCnt |
| Total Community Benefit Expns | $335,046 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $335,046 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00870 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,122,663 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,609,100 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2 | PersonsServedCnt |
| Total Community Benefit Expns | $3,926 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,897 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,029 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 178 | PersonsServedCnt |
| Total Community Benefit Expns | $9,461,635 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,610,997 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $337,075 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00880 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 359 | PersonsServedCnt |
| Total Community Benefit Expns | $16,807 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,807 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 10 | PersonsServedCnt |
| Total Community Benefit Expns | $500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 284 | PersonsServedCnt |
| Total Community Benefit Expns | $73,273 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $73,273 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 134 | PersonsServedCnt |
| Total Community Benefit Expns | $37,606 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $37,606 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 787 | PersonsServedCnt |
| Total Community Benefit Expns | $128,186 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $128,186 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00330 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 965 | PersonsServedCnt |
| Total Community Benefit Expns | $9,589,821 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,610,997 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $465,261 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01210 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $387,454 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,457,039 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,835,127 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,378,088 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Providence St Joseph Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 Thirteenth Ave East | AddressLine1Txt |
| City | Polson | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59860 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | montana.providence.org/hospitals/ | WebsiteAddressTxt |
| State License | 13223 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Providence St Joseph Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 14 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part VI | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | communitybenefit.providence.org/community-health-needs-assessments/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 350.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www2.providence.org/obp/docs/mt-charity-care-policy.pdf | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www2.providence.org/obp/docs/financialassistancerequest(english).pdf | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.providence.org/obp/mt/financial-assistance | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Providence St. Joseph Medical Center | Part V, Section B, Line 5: In March 2014, a diverse group of community members (Steering committee) representing various organizations and populations within the community (e.g. public health, elderly, uninsured) came together first to discuss health concerns in the community and offer their perspective in designing the survey instrument prior to data collection.Steering Committee:Brandy Allison - Clinic Manager, Providence St. Joseph Medical CenterBrian Wilson, PT, OCS - Manager of Rehabilitations Services Department & Better Health Improvement Specialist (BHIS), Providence St. Joseph Medical CenterEmily Colomeda, RN, MPH - Public Health Nurse, Health Services Director, Lake County Health DepartmentErin Rumelhart, RN - Director of Nursing, Providence St. Joseph Medical CenterDr. Garry Pitts, DDS - Director, Confederated Salish and Kootenai Tribes Dental ProgramHeather Knutson - Mayor, City of PolsonDr. Jeremy Mitchell, DO - Family Medicine, Providence St. Joseph Medical CenterRic Smith - Real Estate Agent, Century 21Robert McDonald - Tribal Communications Director, Confederated Salish and Kootenai TribesSt. Joseph Medical Center Mission and Values Sub-committee members:Dr. Adam Smith, DO - Chief Medical Officer, Providence St. Joseph Medical CenterBrodie Moll - Chief Executive Officer, Mission Mountain EnterprisesCaroline McDonald - Director, Best Beginnings Children's PartnershipCaryl Cox - Hospital and School district board memberDuane Lutke - Director, Area VI Agency on AgingErin Rumelhart, RN - Director of Nursing, Providence St. Joseph Medical Center Gale Decker - Lake County CommissionerJackie Cripe - Business owner and chair of the committeeJames Kiser - Chief Executive Officer, Providence St. Joseph Medical CenterJohn Payne - Chaplin, St. Joseph Medical CenterKaren Myers - Regional Director of Mission Integration, Providence Health and Services, Western Montana Region.Landon Godfrey, Pharm. D. - Chief of Hospital Operations, Providence St. Joseph Medical CenterMerry Hutton - Regional Manager of Community Benefit, Providence Health and Services, Western Montana Region.Shiloh McCreedy, RN - Discharge Planner, Providence St. Joseph Medical CenterTammy Walston - Manager, Area VI Agency on AgingVincent River Ph.D. - Psychologist, Polson, MT |
| Providence St. Joseph Medical Center | Part V, Section B, Line 6b: National Rural Health Resource Center, Salish & Kootenai Tribes, Lake County Public Health Department, Best Beginnings Children's Partnership, Lake County Sheriff's Department, Western Montana Mental Health Center |
| Providence St. Joseph Medical Center | Part V, Section B, Line 11: Substance abuse - One in five babies born at Providence St. Joseph Medical Center are drug affected, 88 percent of those babies are born to Native American mothers. Survey and focus group data indicate that substance abuse is of major concern and impact on the community at large. The Obstetrical nursing staff and nursing leadership are currently engaged and will continue to strengthen relations and participation with the Best Beginnings Children's Partnership which addresses the needs of pregnant mothers and children from 0-8 years old. Providence St. Joseph Medical Center primary care providers utilize a uniform process in helping patients manage chronic pain with evidence based medicine approaches, common sense prescribing practices and a collaborative approach with their patients. Access to health care services - Access to both primary care and specialty care are limited due to the remoteness of the community, appointment availability and financial concerns such as insurance or ability to pay for services. Providence St. Joseph Medical Center is establishing a relationship with Missoula Surgical Associates to provide regular access to high quality surgical services at our facility. A new primary care provider will ease the burden of appointment delays. A walk-in clinic has been established with an average wait time of 12 minutes. The hospital staffs financial counselors to facilitate insurance enrollment, establish qualification for charity care and/or help patients establish payment plans. Providence St. Joseph Medical Center is currently #2 in the state for rates of charity care. Access to mental health services - Community concern regarding mental health is on the rise, 18.5 percent of residents report being depressed and the State of Montana has the highest rate of suicide in the nation. Providence St. Joseph Medical Center has donated land and will continue to partner with: Western Montana Mental Health, the Confederated Salish and Kootenai Tribes and the Lake County Sheriff's Office to ease the way for a mental health crisis stabilization center.Other efforts include pursuing affiliations that will allow access to licensed clinical social workers and other mental health professionals in the primary care setting. The establishment of contract with Western Montana Mental Health Services is working to meet the needs of the patients with acute mental health crises. Additionally, one full-time LCSW in-patient medical home is being funded by a grant through the Montana Mental Health Trust. Telepsych services will be available to help with acute mental health crises.Healthy behaviors - Impression of community health is falling, obesity is a top-three health concern, motor vehicle accidents are the leading cause of death in children in Lake County, and unintentional injuries are a top-three cause of death. Providence St. Joseph Medical Center nursing and provider staff will continue to grow relationships with the public school system to offer education to school aged students on water safety, DUI and career path development. The successful Diabetes Prevention Program will continue to be offered. The Patient Centered Medical Home will continue to expand efforts to deliver coordinated care in the management of chronic diseases. The following needs not currently addressed:The crime rates per capita in Lake County are high, however most of the serious crimes occur within the family unit. There are local resources, primarily law enforcement from multiple agencies that are working to reduce the burden of violence in this community. Transportation is continually reported as a major barrier in receiving timely and appropriate health care services in this community. The Confederated Salish and Kootenai Tribes operate a free or low-fare bus that has a wide service area to all community members. St. Joseph Medical Center will continue to refer patients to this service as it is needed. |
| Providence St. Joseph Medical Center | Part V, Section B, Line 20e: Financial Assistance information along with payment options are given on each billing statement to the patient. |
| Part V, Section B, Line 7a | communitybenefit.providence.org/community-health-needs-assessments/ |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - Prov St Joseph Assisted Living Ctr | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 Seventeenth Ave East | AddressLine1Txt |
| City | Polson | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59660 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Assisted Living | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | The PH&S sliding fee scale set forth in Attachment B will be used to determine the amount of financial assistance to be provided in the form of a discount of 75 percent for patients or guarantors with incomes between 301% and 350% of the current federal poverty level after all funding possibilities available to the patient or guarantor have been exhausted or denied and personal financial resources and assets have been reviewed for possible funding to pay for billed charges. Financial assistance may be offered to patients or guarantors with family income in excess of 350% of the federal poverty level when circumstances indicate severe financial hardship or personal loss. |
| Part I, Line 6a: | In addition to providing its own smaller Community Benefit Report, St. Joseph's Community benefit information is included in the consolidated report for Providence Health & Services.Please see: http://communitybenefit.providence.org/ |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 387,454. |
| PART I, LINE 7B | This facility is reimbursed 100% of cost by Medicaid. In addition, they received a sizable Disproportionate Share Hospital bonus to cover the cost of the uninsured. |
| Part III, Line 2: | See Part III, Line 4. |
| Part III, Line 4: | The Health System provides for an allowance against patient accounts receivable for amounts that could become uncollectible. The Health System estimates this allowance based on the aging of accounts receivable, historical collection experience by payor, and other relevant factors. There are various factors that can impact the collection trends, such as changes in the economy, which in turn have an impact on unemployment rates and the number of uninsured and underinsured patients, the increased burden of copayments to be made by patients with insurance coverage and business practices related to collection efforts. These factors continuously change and can have an impact on collection trends and the estimation process used by the Health System. The Health System records a provision for bad debts in the period of services on the basis of past experience, which has historically indicated that many patients are unresponsive or are otherwise unwilling to pay the portion of their bill for which they are financially responsible. |
| Part III, Line 8: | It is Providence's policy to exclude any Medicare shortfall from Community Benefit information. The amount reported on Part III, Section B, Line 6, was determined by applying the Cost-to Charge Ratio to the Medicare revenue. |
| Part III, Line 9b: | Billing and Collection PracticesProvidence has written policies about when and under whose authority patient debt is advanced for collection, and uses its best efforts to ensure that patient accounts are processed fairly and consistently.Providence ensures that practices to be used by their outside (non-hospital) collection agencies conform to the standards set forth in this policy, and obtains written commitments from such agencies that they will adhere to those standards. Providence also conducts an assessment of each collection agency's adherence to the policy. Such assessments are conducted at least annually.At time of billing, we provide to all low-income uninsured patients the same information concerning services and charges provided to all other patients who receive care at the hospital.When sending a bill to a patient, Providence includes a) a statement that indicates that if the patient meets certain income requirements the patient may be eligible for a government-sponsored program or for financial assistance from the hospital; and b) a statement that provides the patient with the name and telephone number of a hospital employee or office from whom or which the patient may obtain information about Providence's financial assistance policies for patients and how to apply for such assistance.Any patient seeking financial assistance from Providence (or the patient's legal representative) provides the individual facility with information concerning health benefits coverage, financial status (i.e. income, assets) and any other information that is necessary for the hospital to make a determination regarding the patient's status relative to Providence's financial assistance policy, discounted payment policy, or eligibility for government-sponsored programs.For patients who have an application pending determination for either government-sponsored coverage or for the hospitals own financial assistance program, Providence will not knowingly send that patient's bill to a collection agency.Eligibility for financial assistance will be determined as closely as possible to the date of service. |
| Part VI, Line 2: | We recognize that caring for the poor and vulnerable is not a task we can do on our own. On a routine basis we conduct a formal community assessment to determine who in our communities is experiencing the greatest need. This outreach connects us to many not-for-profits and social service agencies as well as care providers and their clients in the communities. To ensure that we conduct a comprehensive assessment, our process includes research, meetings, interviews, focus groups and surveys.Additionally, Providence ministries have community and foundation boards. The civic leaders that serve on Providence Boards connect our Mission with a local perspective on community needs.Our assessment findings are assembled to make certain we understand and respond to local and regional needs, which often vary from one city or county to another. Identified areas of need not only guide our community benefit giving, but also guide our strategic planning. We believe meaningful community needs assessment provides insight into the complete community benefit that is required, beyond just free and discounted care.In March 2014, a diverse group of community members (Steering committee) representing various organizations and populations within the community (e.g. public health, elderly, uninsured) came together first to discuss health concerns in the community and offer their perspective in designing the survey instrument prior to data collection.Through the Frontier Medicine Better Health Partnership (FMBHP) Medicare innovation grant, Providence St. Joseph Medical Center was able to partner with the Montana Office of Rural Health (MORH) and National Rural Health Resource Center (NRHRC) to facilitate development and distribution of surveys which were mailed out to the residents in Providence St. Joseph Medical Center's service area in June 2014. Additional paper surveys were available at the county library, county public health office and the hospital lobby. An online version was also distributed via email campaign and Providence St. Joseph Medical Center's Facebook page to capture the broadest audience possible. Finally, five focus group sessions were held at a variety of locations such as a local senior citizen center, public library and at a local, tribal owned power company's meeting hall.The Steering Committee and the Mission and Values Sub-Committee of the Providence St. Joseph Medical Center Board and the administrative team met as one group once and individually on numerous occasions for results review and discussion of the data.From the survey data, community input, recommendations from the steering committee and Mission and Values sub-committee, the Providence St. Joseph administrative team distilled four key items to focus community benefit efforts over the next three years. This was then developed into a community health implementation plan. |
| Part VI, Line 3: | Communication to the Public:Providence hospitals post notices regarding the availability of financial assistance to low-income uninsured patients. These notices are posted in visible locations throughout the hospital such as admitting/registration, billing office, emergency department and other outpatient settings.Every posted notice regarding financial assistance policies contains brief instructions on how to apply for financial assistance or a discounted payment. The notices also include a contact telephone number that a patient or family member can call to obtain more information.Providence ensures that appropriate staff members are knowledgeable about the existence of the hospital's financial assistance policies. Training is provided to staff members (i.e., billing office, financial department, etc.) who directly interact with patients regarding their hospital bills. Hospital staff (financial counselors) are available to meet with patients or families to discuss their coverage options, concerns about billing and application support for programs that they may eligible for. When communicating to patients regarding their financial assistance policies, Providence attempts to do so in the primary language of the patient, or his/her family, if reasonably possible, and in a manner consistent with all applicable federal and state laws and regulations.Providence shares their financial assistance policies with appropriate community health and human services agencies and other organizations that assist such patients. |
| Part VI, Line 4: | Providence St. Joseph Medical Center is a 22 bed acute care, Joint Commission accredited, critical access hospital located on the Flathead Indian Reservation in Polson, Montana, which is about one and a half hours north of Missoula. Providence St. Joseph Medical Center provides community hospital care for the more than 28,000 residents of Lake County. Providence St. Joseph Medical Center serves a higher percentage of older adults, with 16% of the primary service area's population over the age of 65. With approximately 18% of the population living in poverty, the community is characterized by lower income levels than the national average. The service area where Providence St. Joseph Medical Center is located encompasses rural communities from Lake, Lincoln, Flathead and Sanders counties with approximately 147,000 residents living in an area of 12,967 square miles. Each of these counties is designated a Mental Health Professional Shortage Area by the U.S. Department of Health & Human Services. |
| Part VI, Line 5: | Providence St. Joseph Medical Center management is directed by a community ministry board which helps direct the hospital in its endeavors. The composition of the community ministry board represents the diversity of the community by having representatives from local government, social service agencies, medical providers, independent business representatives and interested community members. The St. Joseph Medical Center Community Ministry Board of Directors reviews and develops the community benefit plan, providing information and insight into community needs and resources and helping set priorities for what community needs are to be addressed. They also receive regular updates on the overall community benefit strategy and specific programs to assess whether the organization is having an impact on the health of the community. The providers and staff and St. Joseph Medical Center provide education to the broader community on certain health benefits, risks and preventative medicine and is provided at no cost. The hospital has been serving the needs of the community since 1916 and has expanded over the years in response to the growing population and changes in health care. As a ministry of Providence Health & Services, Providence St. Joseph Medical Center participates in shared purchasing, information systems and financial management support that benefits the community hospital. Providence St. Joseph Medical Center and Providence Medical group collectively build and support coordinated services across the continuum of care to meet regional residents' needs, while mutually supporting organizational, operational, and fiscal health. Joint ventures include research collaborations (cardiac, neuroscience and oncology) with the University of Montana; affiliations with long term care facilities; and the Indian Health services clinic, among others.Providence St. Joseph Medical Center conducts local assessments to make sure the needs of the community are met. The community ministry board of directors oversees and approves the annual community benefit plan that addresses the health care disparities within the community. The community benefit plan is developed and reviewed annually to ensure that the proposed outcomes are being met. This plan is implemented in concert with others in the community to increase the accountability that we share with them to improve the health of our community and to not duplicate services. Access to mental health services is one of the top priorities of the community and St. Joseph Hospital coordinates the Lake County crisis committee to address both the short and long term solutions. By collaborating with community groups, a new mental health crisis facility is being built, access to tele-psychiatry services in primary care as well as direct services from an LCSW and Advanced practice RN are now in place. Additional efforts are underway to minimize the impact of mothers delivering babies while under the influence of drugs and alcohol through the Best Beginning committee that St. Joseph staff participate on. |
| Part VI, Line 6: | Effective July 1, 2016, Providence Health & Services and St. Joseph Health came together to serve more people in a partnership that joins two remarkable organizations with rich heritages. We are now connected by a new parent organization, Providence St. Joseph Health. Together, over 100,000 of our caregivers (employees) now serve in 50 hospitals, over 800 clinics and a comprehensive range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. All hospitals and other ministries will maintain their current names and identities. This parent structure allows our family of diverse organizations to work together to meet the needs of our communities both today and into the future. |
| Part VI, Line 7, Reports Filed With States | MT |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| Polson Youth Soccer Association | |||||||
| PO Box 1337 | Polson | MT | 59860 | 273147418 | 501(C)(3) | $25,000 | Event Sponsor |
| St Patrick Hospital Foundation dba Providence Montana Health Foundation | |||||||
| 900 N Orange Suite 201 | Missoula | MT | 59802 | 237056976 | 501(C)(3) | $17,743 | Support for Operations |
| Polson Loaves & Fish Pantry Inc | |||||||
| 904 1st St E | Polson | MT | 59860 | 810413726 | 501(C)(3) | $10,000 | Support for local food bank |
| Lake County Community Development Corporation | |||||||
| 407 Main Street PO Box 128 | Ronan | MT | 59864 | 810489999 | 501(C)(3) | $6,000 | Event Sponsor |
| Polson High School | |||||||
| 111 4th Avenue E | Polson | MT | 59860 | 816000545 | Government | $5,735 | Community Educational Program Support |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 5 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | In general the grant requests come directly to the Administrative team. If appropriate in nature, the Admin team may hand off to the Mission and Community needs assessment subcommittee of the Community Board for their recommendation. If it goes to the subcommittee the requesting party comes before the subcommittee to present their need which includes intended use of the funds. Either way the Admin team must give final approval. The Admin Team either sees the deployment of the funds in specific Community projects or will ask for reports from the group on how the funds impacted the specific community project. Most of them come with some sort of formal recognition of St. Joseph as a primary donor. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (35 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Rod F Hochman MD | ||||||||||||||
| President / CEO - Thru 6/16 | $0 | $1,912,650 | $0 | $2,130,271 | $0 | $18,000 | $0 | $25,159 | $0 | $18,384 | $0 | $4,104,464 | $0 | $0 |
| Mike Butler | ||||||||||||||
| President - Eff. 7/16 | $0 | $1,241,463 | $0 | $5,618,732 | $0 | $46,498 | $0 | $324,347 | $0 | $25,286 | $0 | $7,256,326 | $0 | $2,182,191 |
| Todd Hofheins | ||||||||||||||
| EVP/CFO /Treas. Thru 11/16 | $0 | $765,052 | $0 | $762,582 | $0 | $43,806 | $0 | $33,684 | $0 | $26,986 | $0 | $1,632,110 | $0 | $0 |
| Jo Ann Escasa-Haigh | ||||||||||||||
| Interim CFO/Treasurer | $0 | $284,195 | $0 | $465,096 | $0 | $6,125 | $0 | $158,719 | $0 | $9,471 | $0 | $923,606 | $0 | $0 |
| Cindy Strauss | ||||||||||||||
| EVP/Chief Legal Officer | $0 | $657,902 | $0 | $762,672 | $0 | $42,206 | $0 | $35,775 | $0 | $22,491 | $0 | $1,521,046 | $0 | $0 |
| Jeff Fee | ||||||||||||||
| CE/Western MT. Region | $0 | $367,073 | $0 | $214,880 | $0 | $18,000 | $0 | $79,978 | $0 | $22,604 | $0 | $702,535 | $0 | $0 |
| James Kiser | ||||||||||||||
| CEO/PSJMC | $220,475 | $0 | $41,019 | $0 | $18,075 | $0 | $14,130 | $0 | $15,080 | $0 | $308,779 | $0 | $0 | $0 |
| Debra Canales | ||||||||||||||
| EVP/CAO | $0 | $801,127 | $0 | $1,168,376 | $0 | $122,854 | $0 | $598,119 | $0 | $13,490 | $0 | $2,703,966 | $0 | $0 |
| Janice Newell | ||||||||||||||
| SVP/Chief Information Officer | $0 | $576,214 | $0 | $517,269 | $0 | $44,010 | $0 | $18,550 | $0 | $15,548 | $0 | $1,171,591 | $0 | $0 |
| Joel Gilbertson | ||||||||||||||
| SVP/Community Partnerships | $0 | $443,246 | $0 | $350,838 | $0 | $47,943 | $0 | $224,819 | $0 | $23,028 | $0 | $1,089,874 | $0 | $0 |
| Orest Holubec | ||||||||||||||
| SVP/Chief Comm./Ext. Affairs Officer | $0 | $396,372 | $0 | $343,782 | $0 | $42,534 | $0 | $185,290 | $0 | $22,516 | $0 | $990,494 | $0 | $0 |
| Greg Till | ||||||||||||||
| VP/Chief Talent Officer | $0 | $396,660 | $0 | $378,331 | $0 | $1,020 | $0 | $99,936 | $0 | $22,431 | $0 | $898,378 | $0 | $0 |
| Sharon Toncray | ||||||||||||||
| SVP / Chief Labor Employee Counsel | $0 | $408,183 | $0 | $308,273 | $0 | $48,521 | $0 | $221,561 | $0 | $22,167 | $0 | $1,008,705 | $0 | $0 |
| Jack Mudd - Thru 316 | ||||||||||||||
| SVP/Mission Leadership | $0 | $249,590 | $0 | $426,247 | $0 | $42,891 | $0 | $141,404 | $0 | $16,374 | $0 | $876,506 | $0 | $0 |
| Paul Stoddart - Thru 916 | ||||||||||||||
| VP/Marketing | $0 | $239,356 | $0 | $306,938 | $0 | $95,129 | $0 | $11,537 | $0 | $10,844 | $0 | $663,804 | $0 | $0 |
| Robert Hellrigel | ||||||||||||||
| SVP-CE / Senior & Comm. Services | $0 | $393,690 | $0 | $222,195 | $0 | $4,396 | $0 | $174,041 | $0 | $22,748 | $0 | $817,070 | $0 | $0 |
| Mark Gargett | ||||||||||||||
| VP/Digital Integration | $0 | $386,259 | $0 | $224,528 | $0 | $0 | $0 | $42,448 | $0 | $23,522 | $0 | $676,757 | $0 | $0 |
| David Brown | ||||||||||||||
| VP/Strategy & Business Development | $0 | $388,819 | $0 | $311,642 | $0 | $0 | $0 | $203,986 | $0 | $22,444 | $0 | $926,891 | $0 | $0 |
| Debbie Burton | ||||||||||||||
| SVP/ Chief Nrsg. Officer | $0 | $355,010 | $0 | $315,852 | $0 | $42,618 | $0 | $66,297 | $0 | $23,718 | $0 | $803,495 | $0 | $0 |
| Mary Cranstoun | ||||||||||||||
| VP/Total Rewards | $0 | $372,857 | $0 | $272,174 | $0 | $18,000 | $0 | $91,147 | $0 | $23,270 | $0 | $777,448 | $0 | $0 |
| Aaron Martin | ||||||||||||||
| SVP/Strategy & Innovation | $0 | $542,637 | $0 | $292,297 | $0 | $18,000 | $0 | $210,328 | $0 | $8,957 | $0 | $1,072,219 | $0 | $0 |
| Tom McDonagh | ||||||||||||||
| VP/Chief Investment Officer | $0 | $478,005 | $0 | $330,119 | $0 | $41,338 | $0 | $28,774 | $0 | $24,747 | $0 | $902,983 | $0 | $0 |
| Rhonda Medows MD | ||||||||||||||
| EVP/Population Health | $0 | $824,899 | $0 | $698,359 | $0 | $42,442 | $0 | $299,110 | $0 | $21,169 | $0 | $1,885,979 | $0 | $0 |
| Harvey Smith | ||||||||||||||
| SVP/Chief Customer Svc. Officer | $0 | $579,168 | $0 | $628,988 | $0 | $18,000 | $0 | $7,950 | $0 | $15,841 | $0 | $1,249,947 | $0 | $0 |
| Lisa Vance | ||||||||||||||
| SVP/Clinical Program Services | $0 | $571,069 | $0 | $606,964 | $0 | $42,315 | $0 | $110,502 | $0 | $14,943 | $0 | $1,345,793 | $0 | $0 |
| Mike Waters | ||||||||||||||
| VP,CAO/Physician Services | $0 | $426,739 | $0 | $274,903 | $0 | $2,135 | $0 | $172,012 | $0 | $12,011 | $0 | $887,800 | $0 | $0 |
| Amy Compton-Phillips | ||||||||||||||
| EVP/Chief Clinical Officer | $0 | $713,661 | $0 | $303,268 | $0 | $96,564 | $0 | $251,731 | $0 | $27,163 | $0 | $1,392,387 | $0 | $0 |
| Michael Righetti MD | ||||||||||||||
| Physician - Orthopedics | $546,522 | $0 | $52,634 | $0 | $75 | $0 | $13,913 | $0 | $10,859 | $0 | $624,003 | $0 | $0 | $0 |
| Joseph Howard MD | ||||||||||||||
| Physician | $280,231 | $0 | $66,642 | $0 | $75 | $0 | $11,925 | $0 | $9,412 | $0 | $368,285 | $0 | $0 | $0 |
| Kenneth Galewyrick MD | ||||||||||||||
| Physician | $283,904 | $0 | $88,979 | $0 | $75 | $0 | $11,925 | $0 | $9,091 | $0 | $393,974 | $0 | $0 | $0 |
| Robin Hape MD | ||||||||||||||
| Physician - Surgery | $277,433 | $0 | $9,633 | $0 | $16,654 | $0 | $3,975 | $0 | $15,494 | $0 | $323,189 | $0 | $0 | $0 |
| Rebecca Bontadelli MD | ||||||||||||||
| ER Physician | $254,783 | $0 | $37,693 | $0 | $75 | $0 | $13,968 | $0 | $12,763 | $0 | $319,282 | $0 | $0 | $0 |
| Craig Wright MD | ||||||||||||||
| SVP/Physician Services | $0 | $14,760 | $0 | $551,522 | $0 | $553,657 | $0 | $2,107 | $0 | $18,348 | $0 | $1,140,394 | $0 | $0 |
| Jack Friedman | ||||||||||||||
| SVP/Accountable Care & Payor Rel. | $0 | $0 | $0 | $299,327 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $299,327 | $0 | $0 |
| Randy Axelrod MD | ||||||||||||||
| EVP/Clinical & Patient Services | $0 | $0 | $0 | $564,384 | $0 | $854,949 | $0 | $0 | $0 | $0 | $0 | $1,419,333 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | The reporting organization did not provide any of the benefits listed in Part I, Line 1a. However, as part of the related organization's philosophy of transparency, the narrative that follows relates to the compensation and benefits provided by the related organization. Providence Health & Services Expense Reimbursement Procedures include the following policies: Travel or Charter Travel or Travel of Companions Air travel is reimbursable and should be at the least expensive airfare; which permits departures and arrivals at reasonable times and reasonable distance traveled. Employees are encouraged to plan in advance to get available discounts. Airline frequent flyer upgrades will never be reimbursed. First class full fare tickets and charter must be approved by a senior level supervisor. Companion travel will only be reimbursed by the organization for travel related to relocation, and should not exceed two relocation-related visits, unless approved by the Executive Vice President, Chief Administrative Officer (EVP, CAO) of Providence St. Joseph Health. Spouse or Companion Travel. Travel expenses incurred by a PH&S employee's spouse or companion will not be reimbursed by PH&S unless the spouse or companion is required to, or invited to attend a PH&S System-sponsored meeting. These expenses may be considered a taxable benefit by the IRS and if so, will be included on the employee's W- 2. During 2016, there were 21 First Class tickets utilized by Officers, Directors or Key Employees listed on Form 990, Part VII. Tax Indemnifications or Gross-Up Payments - Relocation Providence Health & Services follows the federal and state taxation laws related to relocation expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay the relocation expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the relocation benefits to offset the personal tax burden to the employee for IRS allowable expenses. During 2016, there were 4 Key Employees receiving gross-up payments. The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. Tax Indemnifications or Gross-Up Payments - Financial/Retirement Planning Providence Health & Services follows the federal and state taxation laws related to other expenses paid to the employee or to a third party on the employee's behalf. They are considered income and are therefore subject to payroll taxes. Based on the way Providence has chosen to pay these other expenses, Providence reports reimbursements and payments to vendors as income and these expense payments are reflected on the executive's Form W-2. Providence will gross-up the financial/retirement planning benefits, during 2016 only, to offset the personal tax burden to the employee for IRS allowable expenses. During 2016, there were 4 Officers, 13 Key Employees and 1 Former Key Employee receiving this type of gross-up payment. The amounts reported for these gross-up payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. Housing Allowance or Residence for Personal Use Providence Health & Services provides housing allowances for purposes of relocation assistance only. Providence may pay temporary living expenses for the employee up to a maximum of 90 calendar days. Covered expenses are rent (excluding "rent" which may be paid in order to occupy a new permanent residence until the title clears) and utilities, including heat, electricity, gas, water, local internet and local telephone and garbage services. The EVP, CAO PSJH may approve temporary housing assistance for up to six months when family relocation is delayed to accommodate the school year or equivalent circumstances. Only in extenuating circumstances is housing extended beyond this six month period. During 2016, there were 4 Key Employees receiving relocation/housing program payments. The amounts reported for these relocation/housing payments are included on Schedule J, Part II, Column B (iii) - Other Reportable Compensation on the Form 990. |
| Part I, Lines 4a-b | NONQUALIFIED RETIREMENT PLANS A) SERP = Supplemental Executive Retirement Plan B) DCRP = Defined Contribution Restoration Plan 1) Rod Hochman, MD a) SERP Earned but not Paid - $71,434 2) Cindy Strauss a) SERP Earned but not Paid - $23,073 3) Michael Butler a) SERP Vested but not Paid - $4,194,363 b) SERP Interest Credit - $280,622 4) Jo Ann Escasa-Haigh a) SERP Earned but not Vested - $144,759 5) Debra Canales a) SERP Earned but not Vested - $578,244 6) Rhonda Medows, MD a) SERP Earned but not Vested - $267,369 b) SERP Interest Credit - $11,866 7) Lisa Vance a) SERP Interest Credit - $79,015 8) Janice Newell a) SERP Earned but not Paid - $23,422 9) Amy Compton-Phillips a) SERP Earned but not Vested - $223,438 b) SERP Interest Credit - $8,418 10) Aaron Martin a) SERP Earned but not Vested - $188,376 11) Joel Gilbertson a) SERP Earned but not Vested - $160,455 b) SERP Interest Credit - $39,169 12) Orest Holubec a) SERP Earned but not Vested - $144,707 b) SERP Interest Credit - $19,483 13) Greg Till a) SERP Earned but not Vested - $78,010 b) SERP Interest Credit - $10,002 14) Sharon Toncray a) SERP Earned but not Vested- $172,369 b) SERP Interest Credit - $22,823 15) Jack Mudd a) SERP Earned but not Paid - $5,896 b) SERP Interest Credit - $115,845 16) Debbie Burton a) SERP Earned but not Paid - $16,879 b) SERP Interest Credit - $37,391 17) Mike Waters a) SERP Earned but not Vested - $143,129 b) SERP Interest Credit - $10,334 18) David Brown a) SERP Earned but not Vested - $134,921 b) SERP Interest Credit - $42,528 19) Mary Cranstoun a) SERP Earned but not Vested - $77,234 20) Paul Stoddart a) SERP Interest Credit - $8,530 21) Robert Hellrigel a) SERP Earned but not Vested - $136,978 b) SERP Interest Credit - $10,404 22) Mark Gargett a) SERP Earned but not Paid - $12,295 b) SERP Interest Credit - $11,400 23) Jeff Fee a) SERP Interest Credit - $54,517 24) Randy Axelrod, MD a) SERP Paid - $564,384 25) Craig Wright, MD a) SERP Earned but not Paid - $233,982 26) Kenneth Galewyrick, MD a) Taxable DCRP Earned but not Paid- $7,644 27) Joseph Howard, MD a) Taxable DCRP Earned but not Paid- $7,742 28) Michael Righetti, MD a) Taxable DCRP Earned but not Paid - $23,634 |
| Part I, Lines 4a-b | SEVERANCE 1) Paul Stoddart - $77,130 2) Randy Axelrod - $850,776 5) Craig Wright, MD - $525,300 |
| FORM 990, SCHEDULE J, PART II - EXECUTIVE INCENTIVE PROGRAM | The Providence Executive Incentive Program provides a lump sum award annually as a percent of the executive's base pay. Percent opportunities are aligned with our total compensation philosophy as outlined in Part VI, Section B, Line 15 (Process for determining compensation of top management, officers & key employees). For Providence leaders, the performance award is based on the level of accomplishment of annual system and functional (or market) objectives. In 2016, 60 percent of the participant awards were based on pre-determined organizational goals consistent with Providence's strategic priorities. In 2016 the percent allocation for each of these strategic priorities was as outlined below: System Goals: First-year Turnover - 10% Inpatient Experience - 5% Patient Experience - 5% Medical Group Patient Experience - 5% Community Benefit - 10% Clinical Excellence - 15% Free Cash Flow - 10% The remaining 40% was based on a robust set of function specific goals designed to align critical mission and business drivers. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Montana Facility Finance Authority | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 810302402 | BondIssuerEIN |
| CUSIP | 61204KCB5 | CUSIPNum |
| Bond Issued | 2016-09-28 | BondIssuedDt |
| Issue Price | $7,611,744 | IssuePriceAmt |
| Purpose | SEE PART VI | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $7,611,744 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $20,011 | IssuanceCostsFromProceedsAmt |
| Other Spent Proceeds | $7,587,026 | OtherSpentProceedsAmt |
| Unspent | $4,707 | UnspentAmt |
| Substantial Completion | 2002 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ISSUE A. Part I, QUESTION (f) | Current refunding of the Montana Facility Finance Authority Series 2006B bonds. |
| SCHEDULE K - PART I - BOND ISSUES | The 2016F Series issued by the Montana Facility Finance Authority was issued to cover the refunding of the 2006B Series bonds for both Providence Health & Services - Montana and Providence St. Joseph Medical Center located in Polson, MT. Since this bond issue is spread across two separate legal entities, the amounts shown reflect only the portion allocated directly to Providence St. Joseph Medical Center. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 6 | The sole Corporate Member is Providence Health & Services - Montana dba Providence St. Patrick Hospital. |
| Form 990, Part VI, Section A, line 7a | The powers of the Corporate Member include the provision to appoint the number of Directors, appoint the Board of Directors and to remove such Directors at any time with or without cause. Additionally, the Member may appoint and remove the President/CEO with or without cause after consultation with the Board. |
| Form 990, Part VI, Section A, line 7b | The following powers reside with the Member: To adopt or change the mission, philosophy, and values of the Corporation. To amend or repeal the Articles of Incorporation and the Bylaws of the Corporation. To approve the acquisition of assets, the incurrence of indebtedness or the lease, sale, transfer, assignment or encumbering of the assets, in excess of a specified amount. To approve the dissolution and/or liquidation or the consolidation or merger of the Corporation. To approve the annual operating and capital budget and approval any deviations from the budget exceeding a specified amount. To appoint the Corporation's certified public accountants after receiving recommendation of the Board of Directors. To approve the lending of Corporate funds, other than the purchase of publicly traded securities, to unaffiliated organizations. To approve the closure of any institution or major ministry or work within this Corporation. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is prepared internally by experienced Providence Health & Services staff and reviewed by the internal PH&S Director of Taxes and external tax advisors. The Board of Directors reviewed the Form 990 prior to filing with the IRS. |
| Form 990, Part VI, Section B, line 12c | Providence Health & Services maintains a conflict of interest policy that applies to board members and management of all Providence-related organizations. The purpose of the policy is to guide and direct those serving the Providence Health & Services' corporations and other legal entities so they can (1) fulfill their fiduciary responsibilities and exercise stewardship in ways that promote and protect the best interests of Providence and, (2) avoid situations that create a conflict, or the appearance of a conflict, between the interests of an individual associated with Providence and Providence. On an annual basis, each board member and management level employee must complete and submit an updated conflict of interest statement. Conflict of interest disclosures are reviewed by the System Integrity Department working in conjunction with the Department of Legal Affairs. If it is determined that an actual conflict exists, appropriate follow-up action is taken with the individual to rectify the conflict. |
| Form 990, Part VI, Section B, line 15 | It is Providence's intention to make financial information accessible and transparent. Although the filing of Form 990 provides insight into how Providence achieves its Mission, delivers its programs and stewards its finances, deciphering the information directly from Form 990 can be challenging. The following paragraphs provide further information about the process we use to determine compensation for top management, officers and key employees. Providence has a single fiduciary Board, with responsibility for financial oversight associated with fulfillment of the Providence Mission, developing system policies, protecting the assets entrusted to the organization and overseeing the strategic and operational affairs of Providence's legal entities. Providence also maintains a network of community ministry boards with responsibility for quality of care oversight, community relations, advocacy and community needs assessments. Providence has a consistent compensation philosophy for all of its officers, including our senior executives. Salaries for senior executives are reviewed by the Providence St. Joseph Health Committee and approved by the full Board of Directors, none of whom is a Providence employee. The Board retains an independent consultant each year to review salaries of those in the most significant leadership roles in the organization. Part of the consultant's role is to review an extensive array of compensation surveys of large, not-for-profit health care systems in the United States. Providence is one of the larger health systems in the country, and as such, the Board benchmarks executive compensation against other large, not-for-profit health systems whose revenue is similar to that of Providence. Additionally, Providence's labor market continues to spread across health care and into general industry. Because of this, Providence also takes into consideration general industry for-profit market data, where applicable. Base salaries for Providence executives are generally targeted to the median level of the market, as identified by the independent consultant and reviewed with the Executive Compensation Committee. Each year, the Board Chair conducts a formal performance evaluation of the President/CEO that considers input from the other directors and senior leaders reporting to the President. The evaluation is discussed with the Executive Compensation Committee and then a recommendation is made by the committee to the full Board. The Board Chair and the Chair of the Executive Compensation Committee also meet with an independent consultant to develop a salary recommendation; which is reviewed and approved first by the committee and then by the Board of Directors. Additionally, the President/CEO utilizes the market information provided by the consultant along with formal performance evaluations, to determine salary recommendations for other senior executives. This process includes a rigorous analysis of those recommendations with the Executive Compensation Committee as a part of the review and approval process. Performance incentives allow executives to earn additional compensation if they achieve specific organizational goals for furthering Providence operating commitments and strategic objectives. The Board of Directors conducts a thorough process to ensure performance incentives are aligned with appropriate market practices. The Board's process for executive compensation fully complies with IRS standards and mirrors best practices. |
| Form 990, Part VI, Section C, line 19 | Public disclosure of governing documents, conflict of interest policy and 990 filings are made available to the public upon request. The consolidated financial statements are available on our public Internet site www2.providence.org. All governing policies including the conflict of interest policy, as well as 990 filings are available to employees on the Intranet site. |
| Form 990, Part VII Contact Addresses for Officers, Directors, Etc | James Kiser - 6 Thirteenth Avenue E., Polson, MT 59860. |
| Form 990, Part XI, line 9: | Recipient Organization Adjustment 313,539. Interaffiliate Transfers 4,260,136. Rounding 6. |
| FORM 990, PART XII, LINE 2C - AUDIT & COMPLIANCE | The Providence Health & Services Audit and Compliance Committee assists the Board of Directors with the oversight of the integrity of the financial statements and reporting, the audit process and the internal financial controls and policies; compliance with ethical, legal and regulatory standards and requirements; the independence, qualifications and performance of the internal and external auditors; the System's investment committee; and informs the Board of Directors of critical risk areas and recommended mitigation. |
| FORM 990, PART VII, SECTION A - RELATED ORGANIZATION COMPENSATION | Compensation paid by a related organization for those individuals listed on Part VII, was paid by Providence Health & Services - Washington dba Health System Office EIN# 91-0725998 and not by the reporting organization. |
| FORM 990, PART I, LINE 6 - VOLUNTEERS | Volunteers provided to staff/patients and visitors the following services: Gift Shop: Greet gift shop visitors, and facilitate their purchase of merchandise at the gift shop. Oncology: To act as hostess or host to patients and families at the Cancer Clinic. Surgery Department: To act as hostess or host to patients and families at the Surgery Department waiting room desk. Medical Records Services: To assist the Health Information Management Representative and the Medical Records Office. Cardiopulmonary Rehab: Greet the patients and assist the staff when needed to provide excellent service to our patients. No One Dies Alone/Compassionate Companion Services: The volunteer provides a compassionate presence to the dying person who is expected to pass away within 24 to 48 hours. Ear, Nose, and Throat Clinic (Glacier Ear, Nose, and Throat): Greet and check-in patients, organize paperwork, and help new patients fill out paperwork. |
| FORM 990, PART VII - RELIGIOUS COMMUNITY MEMBERS | As members of the Religious Community, each Sister has taken a vow of poverty as a compulsory part of her religious life. Any compensation for services of a Sister inures only for the benefit of the Community, not the individual members. All payments for services are made directly to the Religious Community. |
| FORM 990, PART V, LINE 1 - ISSUANCE OF FORM 1099 | All 1099s for 2016 were issued by Providence Health & Services - WA. #51-0216586. Therefore, none are shown for the reporting organization. |
| FORM 990, SCHEDULE R - RELATED ORGANIZATIONS | AFFILIATION AGREEMENTS Effective April 1, 2016, the Health System (Providence Health & Services) entered into a business combination agreement with the Institute for Systems Biology (ISB). The transaction was accounted for as an acquisition under ASC 958-805. On July 1, 2016, Providence Health & Services (PHS) and St. Joseph Health System (SJHS) entered into a business combination agreement, the purpose of which was to better serve both organizations' communities, maintain strong traditions of Catholic healthcare, and provide greater affordability and access to healthcare services. As part of the business combination, PHS and SJHS aligned under a single parent corporation, Providence St. Joseph Health, with a consolidated board of directors and cosponsorship from the public juridic persons Providence Ministries and St. Joseph Health Ministry. SJHS provides a full range of care facilities including 16 acute care hospitals, home health agencies, hospice care, outpatient services, skilled nursing facilities, community clinics, and physician groups spanning California, west Texas, and eastern New Mexico. The results of operations of these entities have been included in the combined statements of operations of the Health System since July 1, 2016, the effective date of the business combination. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (110 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Providence Health & Services - Washington | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 510216586 | Healthcare System | WA | 501( c)(3) | Line 3 | Providence Health & Services | 0 | |
| Providence Health & Services - Oregon | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 510216587 | Healthcare System | OR | 501( c)(3) | Line 3 | Providence Health & Services | 0 | |
| Providence Health System - So California | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 510216589 | Healthcare System | CA | 501( c)(3) | Line 3 | Providence Health & Services | 0 | |
| Everett Transitional Care Services | |||||||||||
| PO Box 5128 | Everett | WA | 982065128 | 943264605 | Transitional Care | WA | 501( c)(3) | Line 10 | 0 | N/A | |
| Providence Plan Partners | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 911861964 | Healthcare Services | WA | 501( c)(4) | N/A | PH & S - Oregon | 0 | |
| Providence Health Plan | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 930863097 | Health Service Contractor | OR | 501( c)(4) | N/A | Providence Plan Partners | 0 | |
| Providence Health Assurance | |||||||||||
| 4400 NE Halsey Bldg 2 | Portland | OR | 97213 | 550828701 | Medicaid Healthcare Provider | OR | 501( c)(4) | N/A | Providence Health Plan | 0 | |
| Providence Medical Institute | |||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330283773 | Healthcare | CA | 501( c)(3) | Line 12/Type I | PHS - So California | 0 | |
| Little Company of Mary Ancillary Services Corporation | |||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330844408 | Imaging Services | CA | 501( c)(3) | Line 10 | PHS - So California | 0 | |
| Providence TrinityCare Hospice | |||||||||||
| 5315 Torrance Blvd Suite B1 | Torrance | CA | 90503 | 953264139 | Hospice | CA | 501( c)(3) | Line 10 | PHS - So California | 0 | |
| Providence Blanchet Association | |||||||||||
| 1700 Providence Pl | Centralia | WA | 98531 | 911789266 | Supportive Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| St Luke Association | |||||||||||
| 350 Washington Ave SE | Chehalis | WA | 98352 | 943176618 | Supportive Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Rossi Association | |||||||||||
| 1700 Providence Pl | Centralia | WA | 98531 | 311584166 | Supportive Housing | WA | 501( c)(3) | Line 10 | PH & S - Washington | 0 | |
| Lundberg Association | |||||||||||
| 5921 E Burnside | Portland | OR | 97215 | 911562797 | Supportive Housing | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence St Francis Association | |||||||||||
| 3415 12th Avenue NE | Olympia | WA | 98506 | 943244854 | Supportive Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Peter Claver Association | |||||||||||
| 7101 38th Avenue South | Seattle | WA | 98118 | 311629656 | Supportive Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence St Elizabeth House Association | |||||||||||
| 3201 SW Graham St | Seattle | WA | 98126 | 912171539 | Supportive Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Gamelin House Association | |||||||||||
| 4515 MLK Jr Way S Ste 200 | Seattle | WA | 98108 | 311744654 | Supportive Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| The Gamelin Association | |||||||||||
| 312 North Fourth St | Yakima | WA | 98901 | 911180824 | Supportive Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| The Gamelin Oregon Association | |||||||||||
| 5520 NE Glisan | Portland | OR | 97213 | 911214491 | Supportive Housing | OR | 501( c)(3) | Line 10 | PH & S - Oregon | 0 | |
| The Gamelin California Association | |||||||||||
| 540 23rd St | Oakland | CA | 94612 | 911293869 | Supportive Housing | CA | 501( c)(3) | Line 10 | PHS - So California | 0 | |
| Gamelin Washington Association | |||||||||||
| 1423 First Avenue | Seattle | WA | 98101 | 201910170 | Supportive Housing | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Dethman House | |||||||||||
| 1205 Montello Ave | Hood River | OR | 97031 | 473385506 | Supportive Housing | WA | 501( c)(3) | Line 7 | 0 | N/A | |
| Providence Foundation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 943078543 | Support PH&S and W. HealthConnect | WA | 501( c)(3) | Line 12/Type I | PH & S - Washington | 0 | |
| Providence Alaska Foundation | |||||||||||
| 3300 Providence Drive - B Tower2 | Anchorage | AK | 99508 | 920093565 | Support PHS-Alaska | AK | 501( c)(3) | Line 12/Type I | PH & S - Washington | 0 | |
| Providence St Peter Foundation | |||||||||||
| 413 Lilly Road NE | Olympia | WA | 985065166 | 911097056 | Support Affiliated Tax-Exempt Organization | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Health Care Foundation (Centralia) | |||||||||||
| 914 S Scheuber Road | Centralia | WA | 98531 | 911433382 | Support Providence Centralia Hospital | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Mount St Vincent Foundation | |||||||||||
| 4831 - 35th Avenue SW | Seattle | WA | 981262799 | 911188119 | Support Providence Mount St.Vincent | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| Providence Marianwood Foundation | |||||||||||
| 3725 Providence Point Drive SE | Issaquah | WA | 980297219 | 931554288 | Support Providence Marianwood | WA | 501( c)(3) | Line 12/Type I | PH & S - Washington | 0 | |
| Providence Newberg Health Foundation | |||||||||||
| 1001 Providence Drive | Newberg | OR | 97132 | 930889144 | Support Providence Newberg Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Seaside Hospital Foundation | |||||||||||
| 725 S Wahanna Rd | Seaside | OR | 97138 | 930927320 | Support Providence Seaside Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Community Health Foundation | |||||||||||
| 1111 Crater Lake Ave | Medford | OR | 97504 | 930692907 | Support Providence Medford Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Benedictine Nursing Center Foundation | |||||||||||
| 540 South Main St | Mt Angel | OR | 973629532 | 911940286 | Support Providence Benedictine Nursing Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Portland Medical Foundation | |||||||||||
| 4805 NE Glisan St | Portland | OR | 972132967 | 931231494 | Support Providence Portland Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence St Vincent Medical Foundation | |||||||||||
| 9205 SW Barnes Rd | Portland | OR | 97225 | 930575982 | Support Providence St. Vincent Medical Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Milwaukie Foundation | |||||||||||
| 10150 SE 32nd | Milwaukie | OR | 97222 | 943079515 | Support Providence Milwaukie Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Child Center Foundation | |||||||||||
| 830 NE 47th | Portland | OR | 97213 | 930800140 | Support Providence Child Center | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence TrinityCare Hospice Foundation | |||||||||||
| 5315 Torrance Blvd Suite B1 | Torrance | CA | 90503 | 330261016 | Support TrinityCare Hospice | CA | 501( c)(3) | Line 7 | Providence TrinityCare Hospice | 0 | |
| Providence Little Company of Mary Foundation | |||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 510224944 | Support Little Company of Mary Service Area | CA | 501( c)(3) | Line 7 | PHS - So California | 0 | |
| PH&S FoundationSFVSA & SCVSA | |||||||||||
| 501 S Buena Vista Street | Burbank | CA | 91505 | 953544877 | Support Program & Activities of SFVSA & SCVSA | CA | 501( c)(3) | Line 7 | PHS - So California | 0 | |
| Providence Hospice of Seattle Foundation | |||||||||||
| 425 Pontius Avenue North 300 | Seattle | WA | 981095452 | 912077378 | Support Hospice of Seattle | WA | 501( c)(3) | Line 12/Type I | PH & S - Washington | 0 | |
| Providence Health & Services - Western Washington | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911303277 | Healthcare | WA | 501( c)(3) | Line 3 | Providence MinistriesWHC | 0 | |
| Providence Health & Services | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911549796 | Support Providence Institutions | WA | 501( c)(3) | Line 12/Type II | Providence St Joseph Health | 0 | |
| Providence Health & Services - Montana | |||||||||||
| 500 W Broadway PO Box 4587 | Missoula | MT | 598064587 | 810231793 | Healthcare | MT | 501( c)(3) | Line 3 | PH & S - Washington | 0 | |
| St Thomas Child and Family Center | |||||||||||
| 1710 Benefis Court | Great Falls | MT | 59405 | 810233495 | Early Childhood Education | MT | 501( c)(3) | Line 10 | PH & S - Washington | 0 | |
| Sisters of Providence of Montana Corporation | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 262612415 | Shell Corporation | MT | 501( c)(3) | Line 1 | PH & S - Washington | 0 | |
| Providence Health Care Foundation - Eastern Washington | |||||||||||
| 101 W 8th Ave | Spokane | WA | 99204 | 320014330 | Support PH&S-WA. Ministries in E. WA. | WA | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| St Patrick Hospital Foundation | |||||||||||
| 500 West Broadway PO Box 4587 | Missoula | MT | 598064587 | 237056976 | Support Healthcare in W. Montana | MT | 501( c)(3) | Line 7 | PH & S - Washington | 0 | |
| University of Great Falls | |||||||||||
| 1301 20th Street South | Great Falls | MT | 59405 | 810231777 | Post Secondary Education | MT | 501( c)(3) | Line 2 | Providence Health & Services | 0 | |
| E WA & MT Unemployment Compensation Insurance Trust | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 980579016 | 911082119 | Unemployment Benefits | WA | 501( c)(3) | Line 12/Type I | PH & S - Washington | 0 | |
| Providence Willamette Falls Medical Foundation | |||||||||||
| 1500 Division Street | Oregon City | OR | 97045 | 931003750 | Support Willamette Falls Hospital | OR | 501( c)(3) | Line 12/Type I | PH & S - Oregon | 0 | |
| Providence Hood River Memorial Hospital Foundation Inc | |||||||||||
| 811 13th St | Hood River | OR | 97031 | 930921990 | Support Providence Hood River Memorial Hospital | OR | 501( c)(3) | Line 7 | PH & S - Oregon | 0 | |
| Providence Hospice and Home Care Foundation | |||||||||||
| 2731 Wetmore Avenue Suite 500 | Everett | WA | 98201 | 272552749 | Support Program & Ministries of PHHC | WA | 501(c )(3) | Line 7 | PH & S - Washington | 0 | |
| Providence St Mary Foundation | |||||||||||
| 401 W Poplar St | Walla Walla | WA | 99362 | 452841492 | Support Program & Ministries of SMMC | WA | 501(c )(3) | Line 7 | PH & S - Washington | 0 | |
| Facey Medical Foundation | |||||||||||
| 15451 San Fernando Mission Blvd 200 | Mission Hills | CA | 913451420 | 954322584 | Support Facey Medical Group | CA | 501(c )(3) | Line 7 | PHS - So California | 0 | |
| Swedish Health Services | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 910433740 | Healthcare | WA | 501(c )(3) | Line 3 | Western HealthConnect | 0 | |
| Swedish Edmonds | |||||||||||
| 21601 76th Ave W | Edmonds | WA | 98026 | 272305304 | Healthcare | WA | 501(c )(3) | Line 3 | Western HealthConnect | 0 | |
| Swedish Medical Center Foundation | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 910983214 | Support Swedish Health Services | WA | 501(c )(3) | Line 7 | Swedish Health Services | 0 | |
| Global To Local Health Initiative | |||||||||||
| 2800 South 192nd St 104 | SeaTac | WA | 98188 | 273133200 | Healthcare | WA | 501(c )(3) | Line 7 | Swedish Health Services | 0 | |
| Swedish MJM Holdings | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 273139262 | Holding Company | WA | 501(c )(3) | Line 12/Type I | Swedish Health Services | 0 | |
| Marsha Rivkin Center for Ovarian Cancer Research | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 912054035 | Ovarian Cancer Research | WA | 501(c )(3) | Line 7 | Swedish Health Services | 0 | |
| Western HealthConnect | |||||||||||
| 747 Broadway | Seattle | WA | 98122 | 454171900 | Shell Corporation | WA | 501(c )(3) | Line 12/Type II | PH&S Western Washington | 0 | |
| Inland Northwest Health Services | |||||||||||
| 601 W 1st Avenue | Spokane | WA | 99201 | 911307555 | Healthcare | WA | 501( c)(3) | Line 3 | PH&S - Washington | 0 | |
| Kadlec Regional Medical Center | |||||||||||
| 888 Swift Blvd | Richland | WA | 99352 | 910655392 | Healthcare | WA | 501(c )(3) | Line 3 | Western HealthConnect | 0 | |
| Kadlec Neurological Resource Center | |||||||||||
| 1268 Lee Blvd | Richland | WA | 99352 | 911266345 | Healthcare | WA | 501(c )(3) | Line 10 | Western HealthConnect | 0 | |
| Kadlec Foundation | |||||||||||
| 888 Swift Blvd | Richland | WA | 99352 | 237005501 | Support Kadlec Regional Medical Center | WA | 501(c )(3) | Line 12/Type I | Kadlec Regional Medical Center | 0 | |
| PacMed Clinics | |||||||||||
| 1200 12th Ave S | Seattle | WA | 98144 | 562290878 | Healthcare | WA | 501(c )(3) | Line 10 | Western HealthConnect | 0 | |
| Seattle Science Foundation | |||||||||||
| 550 17th Ave | Seattle | WA | 98122 | 611502822 | Physician Collaboration | WA | 501(c )(3) | Line 7 | Western HealthConnect | 0 | |
| Providence Saint John's Health Center | |||||||||||
| 2121 Santa Monica Blvd | Santa Monica | CA | 90404 | 951684082 | Healthcare | CA | 501(c )(3) | Line 3 | PHS - So California | 0 | |
| John Wayne Cancer Institute | |||||||||||
| 2200 Santa Monica Blvd | Santa Monica | CA | 90404 | 954291515 | Cancer Treatment | CA | 501(c )(3) | Line 4 | Providence Saint John's Health Center | 0 | |
| Saint John's HospitalHealth Center Foundation | |||||||||||
| 2121 Santa Monica Blvd | Santa Monica | CA | 90404 | 956100079 | Support Saint John Health Center & JWCI | CA | 501(c )(3) | Line 7 | Providence Saint John's Health Center | 0 | |
| Providence St Joseph Health | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 98057 | 811244422 | Support PH&S and St. Joseph Health System | WA | 501(c )(3) | Line 12, Type III | 0 | N/A | |
| Institute for Systems Biology | |||||||||||
| 401 Terry Ave N | Seattle | WA | 98109 | 912003593 | Predict, prevent & cure disease | WA | 501(c )(3) | Line 7 | Western HealthConnect | 0 | |
| Providence Saint John's Medical Foundation | |||||||||||
| 20555 Earl St | Torrance | CA | 90503 | 814542216 | Healthcare | CA | 501(c )(3) | Pending | PHS - So California | 0 | |
| Institute for Mental Health & Wellness | |||||||||||
| 1801 Lind Avenue SW 9016 | Renton | WA | 98057 | 814260130 | Mental Healthcare | WA | 501(c )(3) | Line 7 | PH&SSt Joseph Health System | 0 | |
| Covenant Health Network Inc | |||||||||||
| 3345 Michelson Drive Suite 100 | Irvine | CA | 92612 | 461259908 | Healthcare | CA | 501 (C )(3) | Line 12, Type III | St Joseph Health System | 0 | |
| Covenant ACO | |||||||||||
| 3615 19th Street | Lubbock | TX | 79410 | 611573313 | Healthcare | TX | 501 (C )(3) | Line 12, Type I | Covenant Health System | 0 | |
| Covenant Health System | |||||||||||
| 3615 19th Street | Lubbock | TX | 79410 | 752765566 | Healthcare | TX | 501 (C )(3) | Line 3 | St Joseph Health System | 0 | |
| Covenant Health System Foundation | |||||||||||
| 3623 22nd Place | Lubbock | TX | 79410 | 752897026 | Healthcare | TX | 501 (C )(3) | Line 7 | Covenant Health System | 0 | |
| Covenant Medical Group | |||||||||||
| 3420 22nd Place | Lubbock | TX | 79410 | 752743883 | Healthcare | TX | 501 (C )(3) | Line 3 | Covenant Health System | 0 | |
| Covenant Health Partners | |||||||||||
| 3615 19Th Street | Lubbock | TX | 79410 | 463516417 | Healthcare | TX | 501 (C )(3) | Line 12, Type I | Covenant Health System | 0 | |
| HMTS Inc | |||||||||||
| 1 Hoag Drive | Newport Beach | CA | 92658 | 453583707 | Healthcare | CA | 501 (C )(3) | Line 12, Type I | Hoag Memorial Hospital Presbyterian | 0 | |
| Hoag Charity Sports | |||||||||||
| 330 Placentia Ave | Newport Beach | CA | 92663 | 452982422 | Support | CA | 501 (C )(3) | Line 7 | Hoag Hospital Foundation | 0 | |
| Hoag Hospital Foundation | |||||||||||
| 330 Placentia Ave | Newport Beach | CA | 92663 | 953222343 | Fundraising | CA | 501 (C )(3) | Line 7 | Hoag Memorial Hospital Presbyterian | 0 | |
| Hoag Memorial Hospital Presbyterian | |||||||||||
| 1 Hoag Road Box 6100 | Newport Beach | CA | 92663 | 951643327 | Healthcare | CA | 501 (C )(3) | Line 3 | Covenant Health Network | 0 | |
| Home Care Partners | |||||||||||
| 1165 Montgomery Dr | Santa Rosa | CA | 95405 | 680318656 | Inactive | CA | 501 (C )(3) | Line 3 | Santa Rosa Memorial Hospital | 0 | |
| Hospice Of Lubbock | |||||||||||
| 3702 21st Street | Lubbock | TX | 79410 | 752133781 | Healthcare | TX | 501 (C )(3) | Line 10 | Covenant Health System | 0 | |
| Lubbock Methodist Hospital Foundation | |||||||||||
| 3615 19th Street | Lubbock | TX | 79410 | 752220963 | Healthcare | TX | 501 (C )(3) | Line 7 | Covenant Health System | 0 | |
| Methodist Children's Hospital | |||||||||||
| 3610 21st Street | Lubbock | TX | 79410 | 752428911 | Healthcare | TX | 501 (C )(3) | Line 3 | Covenant Health System | 0 | |
| Methodist Hospital Levelland | |||||||||||
| 1900 College Avenue | Levelland | TX | 79336 | 752246348 | Healthcare | TX | 501 (C )(3) | Line 3 | Covenant Health System | 0 | |
| Methodist Hospital Plainview | |||||||||||
| 2601 Dimmitt Road | Plainview | TX | 79072 | 752426010 | Healthcare | TX | 501 (C )(3) | Line 3 | Covenant Health System | 0 | |
| Mission Hospital Regional Medical Ctr | |||||||||||
| 27700 Medical Center Road | Mission Viejo | CA | 92691 | 951643360 | Healthcare | CA | 501 (C )(3) | Line 3 | Covenant Health Network | 0 | |
| Queen Of The Valley Medical Center | |||||||||||
| 1000 Trancas Street | Napa | CA | 94558 | 941243669 | Healthcare | CA | 501 (C )(3) | Line 3 | St Joseph Health System | 0 | |
| Redwood Memorial Foundation | |||||||||||
| 3300 Renner Drive | Fortuna | CA | 95540 | 942779313 | Healthcare | CA | 501 (C )(3) | Line 7 | Redwood Memorial Hospital | 0 | |
| Redwood Memorial Hospital | |||||||||||
| 3300 Renner Drive | Fortuna | CA | 95540 | 941384665 | Healthcare | CA | 501 (C )(3) | Line 3 | St Joseph Health System | 0 | |
| Santa Rosa Memorial Hospital | |||||||||||
| 1165 Montgomery Dr | Santa Rosa | CA | 95405 | 941231005 | Healthcare | CA | 501 (C )(3) | Line 3 | St Joseph Health System | 0 | |
| SRM Alliance Hospital Services (Pvh) | |||||||||||
| 400 North McDowell Blvd | Petaluma | CA | 94954 | 680395200 | Healthcare | CA | 501 (C )(3) | Line 3 | Santa Rosa Memorial Hospital | 0 | |
| St Joseph Health System | |||||||||||
| 3345 Michelson Drive Suite 100 | Irvine | CA | 92612 | 953589356 | Healthcare | CA | 501 (C )(3) | Line 12, Type I | Providence St Joseph Health | 0 | |
| St Joseph Health System Foundation | |||||||||||
| 3345 Michelson Drive Suite 100 | Irvine | CA | 92612 | 330143024 | Healthcare | CA | 501 (C )(3) | Line 7 | St Joseph Health System | 0 | |
| St Joseph Home Care Network | |||||||||||
| 1111 Sonoma Ste 308 | Santa Rosa | CA | 95405 | 680331084 | Healthcare | CA | 501 (C )(3) | Line 10 | St Joseph Health System | 0 | |
| St Joseph Hospital Of Eureka | |||||||||||
| 2700 Dolbeer Street | Eureka | CA | 95501 | 941156596 | Healthcare | CA | 501 (C )(3) | Line 3 | St Joseph Health System | 0 | |
| St Joseph Hospital Of Orange | |||||||||||
| 1100 West Stewart Drive | Orange | CA | 92868 | 951643359 | Healthcare | CA | 501 (C )(3) | Line 3 | Covenant Health Network | 0 | |
| St Jude Hospital Yorba Linda | |||||||||||
| 200 West Center St Promenade | Anaheim | CA | 92805 | 330185031 | Healthcare | CA | 501 (C )(3) | Line 3 | St Joseph Health System | 0 | |
| St Jude Hospital Inc | |||||||||||
| 101 East Valencia Mesa Drive | Fullerton | CA | 92635 | 951643324 | Healthcare | CA | 501 (C )(3) | Line 3 | Covenant Health Network | 0 | |
| St Mary Medical Center | |||||||||||
| 18300 Highway 18 | Apple Valley | CA | 92307 | 951914489 | Healthcare | CA | 501 (C )(3) | Line 3 | Covenant Health Network | 0 | |
| St Mary Of The Plains Hospital Fdn | |||||||||||
| 4000 24th Street | Lubbock | TX | 79410 | 751653181 | Healthcare | TX | 501 (C )(3) | Line 7 | Covenant Health System | 0 | |
| St Joseph Health Northern California LLC | |||||||||||
| 3345 Michelson Drive | Irvine | CA | 92612 | 814791043 | Healthcare | CA | 501 (C )(3) | Line 3 | St Joseph Health System | 0 | |
| Sisters Of St Joseph Of Orange | |||||||||||
| 480 S Batavia | Orange | CA | 92868 | 951643383 | Religious Org | CA | 501 (C )(3) | Line 1 | 0 | N/A | |
| St Joseph Health Ministry | |||||||||||
| 3345 Michelson Drive Suite 100 | Irvine | CA | 92612 | 271666576 | Religious Org | CA | 501 (C )(3) | Line 1 | Sisters of St Joseph of Orange | 0 | |
| Kadlec Auxiliary Inc | |||||||||||
| 888 Swift Blvd | Richland | WA | 99352 | 916033089 | Support Kadlec Regional Medical Center | WA | 501 (C )(3) | Line 12, Type III | Kadlec Regional Medical Center | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (40 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| Alpha Medical Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 912017347 | Outpatient Lab | ID | N/A |
| Broadway Imaging LLC | |||||||
| 500 W Broadway | Missoula | MT | 59802 | 522405971 | Medical Imaging | MT | N/A |
| California Laboratory Associates LLC | |||||||
| 501 Buena Vista | Burbank | CA | 91505 | 273888692 | Outpatient Lab | CA | N/A |
| Center for Specialty Surgery LLC | |||||||
| 11782 SW Barnes Rd | Portland | OR | 97225 | 263638838 | Ambulatory Surgery Center | OR | N/A |
| Clackamas Radiation Oncology Center LLC | |||||||
| 4400 NE Halsey St Bldg II 495 | Portland | OR | 97213 | 260381897 | Radiation Oncology | OR | N/A |
| Ctr for Med Imaging-Bridgeport LLC | |||||||
| 4400 NE Halsey 495 | Portland | OR | 97213 | 260796953 | Imaging - Diagnostics | OR | N/A |
| Ctr for Med Imaging-Tanasbourne LLC | |||||||
| 4400 NE Halsey 495 | Portland | OR | 97213 | 200477972 | Imaging - Diagnostics | OR | N/A |
| Greater Valley Medical Building LP | |||||||
| 501 S Buena Vista St | Burbank | CA | 91505 | 954570858 | Real Estate - MOB | CA | N/A |
| Minor & James Medical PLLC | |||||||
| 515 Minor Avenue 200 | Seattle | WA | 98104 | 911340223 | Physician Clinic | WA | N/A |
| Mountainstar Clinical Laboratories LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 261345983 | Outpatient Lab | MT | N/A |
| Oregon Advanced Imaging LLC | |||||||
| 881 OHare Parkway | Medford | OR | 97504 | 450471748 | Medical Imaging | OR | N/A |
| Oregon Outpatient Surgery Center | |||||||
| 7300 SW Childs Rd | Tigard | OR | 97224 | 223883387 | Ambulatory Surgery Center | OR | N/A |
| PacLab LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 911743952 | Outpatient Lab | WA | N/A |
| Pathology Associates Medical Laboratories LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 270943279 | Outpatient Lab | WA | N/A |
| PETCT Imaging at Swedish Cancer Institute LLC | |||||||
| 1221 Madison Street | Seattle | WA | 98104 | 203132044 | Medical Imaging | WA | N/A |
| Portland Medical Imaging LLC | |||||||
| 4400 NE Halsey 495 | Portland | OR | 97213 | 201054971 | Imaging - Diagnostics | OR | N/A |
| Prov Radiation Oncology Develop Assn LLC | |||||||
| 4400 NE Halsey 495 | Portland | OR | 97213 | 260682491 | Real Estate - MOB | OR | N/A |
| Providence Imaging Center | |||||||
| 3340 Providence Drive | Anchorage | AK | 99508 | 920118807 | Medical Imaging | AK | N/A |
| Providence Partners for Health LLC | |||||||
| 501 S Buena Vista St | Burbank | CA | 91505 | 454041798 | Clinical Quality & Integration | CA | N/A |
| Providence Surgery Center LLC | |||||||
| 902 N Orange St | Missoula | MT | 59802 | 841401625 | Ambulatory Surgery Center | MT | N/A |
| ProvidenceSilverton Rehab LLC | |||||||
| 4400 NE Halsey 425 | Portland | OR | 97213 | 481287267 | Rehab Services | OR | N/A |
| ProvidenceUSP Santa Clarita GP LLC | |||||||
| 11550 Indian Hills Road 160 | Mission Hills | CA | 91345 | 202829660 | Ambulatory Surgery Center | CA | N/A |
| ProvidenceUSP Surgery Ctrs LLC | |||||||
| 11550 Indian Hills Road 160 | Mission Hills | CA | 91345 | 200905938 | Ambulatory Surgery Center | CA | N/A |
| Southern Idaho Regional Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 820511819 | Outpatient Lab | ID | N/A |
| The Madison Spokane Inn LLC | |||||||
| 15 West Rockwood Blvd | Spokane | WA | 99204 | 841606484 | Hotel Services | WA | N/A |
| Tri-Cities Laboratory LLC | |||||||
| 611 N Perry | Spokane | WA | 99202 | 911773986 | Outpatient Lab | WA | N/A |
| HCSA Properties LLC | |||||||
| 1600 M Street NW | Auburn | WA | 98001 | 460620892 | Real estate rental | WA | N/A |
| Covenant Long-Term Care LP | |||||||
| 4000 24th Street | Lubbock | TX | 79410 | 205033419 | Healthcare | TX | N/A |
| Heritage Investment Group I LLC | |||||||
| 500 S Main Street Ste 1000 | Orange | CA | 92868 | 271000061 | Investments | CA | N/A |
| Hoag Orthopedic Institute | |||||||
| 1 Hoag Drive Box 6100 | Newport Beach | CA | 92658 | 611588294 | Healthcare | CA | N/A |
| Lubbock Surgery Center Ltd | |||||||
| 4000 24th Street | Lubbock | TX | 79410 | 752177401 | Healthcare | TX | N/A |
| Methodist Diagnostic Imaging | |||||||
| 4000 24th Street | Lubbock | TX | 79410 | 752343261 | Healthcare | TX | N/A |
| Mission Ambulatory Surgicenter Ltd | |||||||
| 27800 Medical Center Road Ste 362 | Mission Viejo | CA | 92691 | 330355575 | Healthcare | CA | N/A |
| Newport Imaging Center | |||||||
| 360 San Miguel | Newport Beach | CA | 92660 | 330191776 | Healthcare | CA | N/A |
| SHA LLC | |||||||
| 12940 North Highway 183 | Austin | TX | 78750 | 752569094 | Healthcare | TX | N/A |
| St Joseph Physician Ventures I LLC | |||||||
| 1100 West Stewart Drive | Orange | CA | 92868 | 454521884 | Real Estate | CA | N/A |
| North Bay Endoscopy Center | |||||||
| 1383 N McDowell Blvd Suite 110 | Petaluma | CA | 94954 | 611559876 | Healthcare | CA | N/A |
| Southern California Surgery Center LLC | |||||||
| 18321 Ventura Blvd Ste 740 | Tarzana | CA | 91356 | 330939000 | Healthcare | CA | N/A |
| Mission Viejo Physician Partners I LLC | |||||||
| 27700 Medical Center Road | Mission Viejo | CA | 92691 | 471559873 | Healthcare | CA | N/A |
| Advanced Surgery Institute LLC | |||||||
| 1739 4th Street | Santa Rosa | CA | 95404 | 262299255 | Healthcare | CA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (23 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Providence Health Ventures Inc | ||||||||||||
| 4101 Torrance Blvd | Torrance | CA | 90503 | 330122216 | Investment | CA | N/A | C | 0 | |||
| Caron Health Corporation | ||||||||||||
| 510 W Front St | Missoula | MT | 59802 | 810486082 | Medical Physician Service | MT | N/A | C | 0 | |||
| Providence Health Care Ventures Inc | ||||||||||||
| 101 W 8th Ave TAF C-9 | Spokane | WA | 99204 | 900155714 | Clinical/Medical Lab | WA | N/A | C | 0 | |||
| Providence Physician Services Co | ||||||||||||
| 101 W 8th Ave TAF C-9 | Spokane | WA | 99204 | 911216033 | Clinical/Medical Lab | WA | N/A | C | 0 | |||
| Yakima Medical Arts Inc | ||||||||||||
| 611 N Perry 100 | Spokane | WA | 99202 | 910787963 | Rental Real Estate | WA | N/A | C | 0 | |||
| Bourget Health Services Inc | ||||||||||||
| PO Box 2687 | Spokane | WA | 99220 | 911354431 | Clinical/Medical Lab | WA | N/A | C | 0 | |||
| 1221 Madison Street Owners Assoc | ||||||||||||
| 747 Broadway | Seattle | WA | 98122 | 201954319 | Owners' Association | WA | N/A | C | 0 | |||
| Western HealthConnect Ventures Inc | ||||||||||||
| 1801 Lind Ave SW 9016 | Renton | WA | 98057 | 800953654 | Investment | WA | N/A | C | 0 | |||
| PHN Holdings | ||||||||||||
| 20555 Earl Street | Torrance | CA | 90503 | 461814184 | Strategic Planning Services | CA | N/A | C | 0 | |||
| Providence Health Network | ||||||||||||
| 20555 Earl Street | Torrance | CA | 90503 | 800886966 | Prepaid Healthcare | CA | N/A | C | 0 | |||
| Pioneer Innovations Inc | ||||||||||||
| 800 5th Ave 10th Floor | Seattle | WA | 98104 | 364818191 | Healthcare Innovations | WA | N/A | C | 0 | |||
| Vinserra Inc | ||||||||||||
| 1328 22nd Street | Santa Monica | CA | 90404 | 953943315 | Investment | CA | N/A | C | 0 | |||
| American Unity Group Ltd | ||||||||||||
| Captive Insurance | N/A | C | 0 | 90 Pitts Bay Road HM08 Pembroke | BD | BD | ||||||
| Coastal Management Services Organization | ||||||||||||
| 1 Hoag Drive Box 6100 | Newport Beach | CA | 92658 | 330676831 | Healthcare | CA | N/A | C | 0 | |||
| Datu Health Inc | ||||||||||||
| 16150 Main Circle Dr Suite 250 | Chesterfield | MO | 63017 | 463070062 | IT Svcs | DE | N/A | C | 0 | |||
| Hoag Management Services Inc | ||||||||||||
| 1 Hoag Drive Box 6100 | Newport Beach | CA | 92658 | 330731587 | Healthcare | CA | N/A | C | 0 | |||
| Lubbock Methodist Hosp Practice Mgmt | ||||||||||||
| 2107 Oxford Street Ste 300 | Lubbock | TX | 79410 | 752578995 | Inactive | TX | N/A | C | 0 | |||
| Lubbock Methodist Hospital Svcs | ||||||||||||
| PO Box 120 | Lubbock | TX | 79410 | 752118585 | Healthcare | TX | N/A | C | 0 | |||
| Mission Viejo Medical Ventures | ||||||||||||
| 27800 Medical Center Rd 354 | Mission Viejo | CA | 92691 | 330212905 | Healthcare | CA | N/A | C | 0 | |||
| St Joseph Health | ||||||||||||
| 3345 Michelson Drive Suite 100 | Irvine | CA | 92612 | 462340232 | Holding Company | CA | N/A | C | 0 | |||
| St Joseph Health Source Inc | ||||||||||||
| 3345 Michelson Drive Suite 100 | Irvine | CA | 92612 | 461900168 | Healthcare | CA | N/A | C | 0 | |||
| St Joseph Prof Svcs Enterprses Inc | ||||||||||||
| 3345 Michelson Drive Suite 100 | Irvine | CA | 92612 | 330155323 | Healthcare | CA | N/A | C | 0 | |||
| Ophie Healthcare Services Inc | ||||||||||||
| 3345 Michelson Drive Suite 100 | Irvine | CA | 92612 | 271002825 | Healthcare | CA | N/A | C | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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